laboratory medicine investigations

University Hospital Southampton NHS Foundation Trust G3.7a LABORATORY MEDICINE

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UHSFT Pathology Laboratory Medicine List of Investigations

For information on the basis of reference intervals or decision limits, please contact the laboratory Please note multiple requests and cascade requests have a cumulative effect on turnaround times. Please contact the laboratory if an expected result time is required.

DEPARTMENT/TEST Section / Area code

Units TAT days(working)

Special requirements

CHEMICAL PATHOLOGY

RAPID TURNAROUND – SEND ONLY 6 ML SERUM SEPARATOR GEL (SST BUFF TOP) BLOOD SAMPLE FOR ALL TESTS UNLESS OTHERWISE STATED. FOR PAEDIATRIC/CHILDREN SEND FULL 2 ML PAEDIATRIC LITHIUM HEPARIN BLOOD SAMPLE

RENAL PROFILE

SODIUM Automated mmol/L <1

POTASSIUM Automated mmol/L <1

CREATININE Automated umol/L <1

BONE PROFILE

CALCIUM (actual NOT adjusted) Automated mmol/L <1

ALBUMIN Automated g/L <1

TOTAL PROTEIN Automated g/L <1

LIVER PROFILE

ALT Automated iu/L <1

ALBUMIN Automated g/L <1

ALP Automated iu/L <1

BILIRUBIN (TOTAL) Automated umol/L <1

TOTAL PROTEIN Automated g/L <1 OTHER AUTOMATED LABORATORY TESTS

(EXCLUDING URINE TESTS)

ACE Automated iu/L <1 SST or CLOTTED


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CHEMICAL PATHOLOGY

AFP Automated ku/L <1

ALPHA-1 ANTITRYPSIN Automated g/L 2 SST

AMMONIA Automated umol/L 1 EDTA-SEND IMMEDIATELY

AMYLASE Automated iu/L <1

AST Automated iu/L <1

BICARBONATE Automated mmol/L <1

BILE ACIDS Automated umol/L <1 SST

BILIRUBIN - DIRECT Automated umol/L <1

BILIRUBIN - NEONATAL Automated umol/L <1

CA 125 Automated ku/L 1 SST

CA19-9 Automated ku/L 1 SST

CARBAMAZEPINE Automated mgl/L <1 Collect trough level

CEA Automated ug/L 1 SST

CHLORIDE Automated mmol/L <1

CHOLESTEROL Automated

mmol/L <1

CK (creatine kinase) Automated iu/L <1

CORTISOL (PLASMA) Automated nmol/L 1 SST

C-REACTIVE PROTEIN (CRP) Automated mg/L <1

DIGOXIN Automated

nmol/L <1 COLLECT AT LEAST 6 HOURS POST DOSE

ETHANOL (alcohol) Automated mg/100ml 7 FLUORIDE/OXALATE

FERRITIN Automated ug/L <1

FOLATE (PLASMA) Automated ug/L <1

FREE T3 Automated pmol/L <1

FREE T4 Automated pmol/L <1


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CHEMICAL PATHOLOGY

FSH Automated iu/L <1

GAMMA GT Automated iu/L <1

GLUCOSE Automated mmol/L <1 FLUORIDE OXALATE

HAPTOGLOBIN Automated g/L <1 SST

hCG Automated iu/L <1

HDL CHOLESTEROL Automated mmol/L <1

IRON Automated umol/L <1

LDH Automated iu/L <1

LH Automated

iu/L <1

LITHIUM Automated

mmol/L <1 SST or CLOTTED. Collect at least 10 hrs post dose

MAGNESIUM Automated mmol/L <1

METHOTREXATE Automated umol/L 4 hours SST

OESTRADIOL Automated pmol/L <1

OSMOLALITY- SERUM/PLASMA Automated mOsm/KgH2O <1

PARACETAMOL Automated mg/L <1

PHENOBARBITONE Automated mg/L <1 collect trough level

PHENYTOIN Automated mg/L <1 collect trough level

PHOSPHATE Automated mmol/L <1

PROGESTERONE Automated mmol/L <1

PROLACTIN Automated mu/L <1

PSA Automated ug/L <1

PTH Automated pmol/L 2 LI/HEP - SEND TO LAB WITHIN 8 HOURS

SALICYLATE Automated mg/L <1

SHBG Automated nmol/L 1 SST


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CHEMICAL PATHOLOGY

TESTOSTERONE Automated nmol/L <1 SST

THEOPHYLLINE Automated mg/L <1 collect trough level

TRANSFERIN Automated g/L <1

TRIGLYCERIDES Automated mmol/L <1

TROPONIN - I Automated

ng/L <1 SST (routine requests) OR BD Rapid Serum tube (Emergency Department Low risk chest pain pathway ONLY)

TSH Automated mu/L <1

URATE (uric acid) Automated umol/L <1

UREA (nitrogen) Automated mmol/l <1

VALPROATE Automated mg/L <1 collect trough level

VITAMIN B 12 Automated ng/L <1

VITAMIN D, 25-OH VITAMIN D (25-OH-CHOLECALCIFEROL)

Automated (routine method)

nmol/L <1 SST

GENERAL BIOCHEMISTRY TESTS (including urine tests)

17 OH PROGESTERONE - BLOOD SPOT

Chromatography nmol/L 11 GUTHRIE CARD

17 OH PROGESTERONE – SERUM

Chromatography nmol/L 5 SST OR HEPARIN

5 –HIAA Chromatography umol/24 hours 5 24h URINE ONLY – PRESERVED WITH GLACIAL ACETIC ACID

ACTH Special Biochem

ng/l 2 EDTA PLASMA TO BE RECEIVED IN LAB TO BE SEPARATED AND FROZEN WITHIN 24 HOURS

ACYL CARNITINES (BLOOD SPOT)

Chromatography N/A 5 GUTHRIE CARD (from Li Hep plasma

ALBUMIN (URINE) Automated mg/L 1 RANDOM URINE

ALDOSTERONE pmol/L 5 EDTA IF RENIN ALSO REQUIRED


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CHEMICAL PATHOLOGY

Special Biochem SST OK IF ALDO REQUEST ONLY

ALK PHOS ISO ENZYMES Special Biochem qualitative 10 SST

ALPHA-1 AT PHENOTYPE Special Biochem qualitative 10 SST

AMINO ACIDS (CSF) Chromatography umol/L 5 CSF

AMINO ACIDS (PLASMA) Chromatography umol/L 5 LI/HEP or SST

AMINO ACIDS (URINE) – FOR CYSTINURIA ONLY

Chromatography umol/mmol creat

5 RANDOM URINE

ANDROSTENEDIONE (SERUM) Chromatography nmol/L 5 SST

C-PEPTIDE Special Biochem pmol/L 5 SST OR LI/HEP - SEND TO LAB WITHIN 2 HOURS

CAERULOPLASMIN Automated mg/L 2 SST

CALCITONIN Special Biochem ng/L 2 FASTING A.M. PLAIN SAMPLE / SST / Li HEP

CALCIUM (URINE)

Automated mmol/spec mmol/spec mmol/mmol crea

1 24h PREFERRED, CHILDREN RANDOM

CARBOXYHAEMOGLOBIN Critical Care Lab

% 1 Whole blood Lithium Heparin – Send to Main Lab.

CHOLINESTERASE - PHENOTYPE Send Away 10 SST or CLOTTED

CITRATE (URINE) Automated mmol/spec 6 24h URINE COLLECTION

CITRATE (RANDOM URINE) Automated mmol/mmol

creat 6 RANDOM URINE

CORTISOL (BLOOD SPOT) Special Biochem nmol/L 10 GUTHRIE CARD

CORTISOL (SALIVA) Special Biochem nmol/L 10 SALIVA

CORTISOL (URINE) Special Biochem nmol/spec 5 24h URINE COLLECTION

CREATININE CLEARANCE Automated mL/min 1 24h URINE COLLECTION AND SST

CREATININE (URINE) Automated mmol/L 1 URINE

CREATININE (FLUID) Automated umol/L 1 24h URINE COLLECTION


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CHEMICAL PATHOLOGY

CICLOSPORIN Automated ug/L 1 EDTA

CYSTINE Chromatography umol/mmol

creat 10 URINE

DHEA-SULPHATE Chromatography umol/L 5 SST

DRUG SCREEN Toxicology 7 RANDOM URINE

ELF test (enhanced liver fibrosis) Special Biochem

None SST / SERUM ONLY REQUIRES HA, P3NP & TIMP ANALYSIS

ERYTHROPOIETIN (EPO) Special Biochem IU/L 2 SST

FAECAL ELASTASE Special Biochem ug E1/g stool 5 RANDOM FAECES

GROWTH HORMONE (SERUM) Special Biochem ug /L 2 SST

HBA1c Special Biochem

mmol/mol 2 EDTA - PLEASE ENSURE YOU SEND A SEPARATE SAMPLE

Homocysteine Special Biochem

umol/l 5 Lithium heparin plasma or EDTA plasma. Patients must be fasting and the sample separated and frozen at -collection.

HAEM PIGMENTS Automated

Abs Unit 4 hours

HMMA & HVA (neuroblastoma screen in children)

Chromatography umol/mmol creat

5 URINE

HYALURONIC ACID Special Biochem

ug/L 5 SST ONLY

HYDROXYBUTYRATE Toxicology mmol/L 12 CLOTTED

IGF-1 Special Biochem nmol/L 2 SST

INSULIN Special Biochem mu/L 5 SST - SEND TO LAB WITHIN 2 HOURS

LACTATE (BLOOD) Critical Care Lab mmol/L 1 Lithium heparin or SST – SEND TO LAB WITHIN 10 MINUTES of


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CHEMICAL PATHOLOGY

venesection.

LACTATE (CSF) Critical Care Lab

mmol/L 1 Plain sample only (no anticoagulant) - SEND TO LAB WITHIN 10 MINUTES of venesection

MAGNESIUM (URINE) Automated mmol/L 1 24 HR URINE COLLECTION: Bottle preserved with 20mL 6M HCl.

METANEPHRINES - URINE (Normetanephrine, Metanephrine and 3-Methoxytyramine)

Chromatography umol/24 hr or umol/mmol creatinine

5 24h URINE COLLECTION IN ACETIC ACID (Adults) or RANDOM

URINE (Children, for phaeochromocytoma screen only)

METHAEMALBUMIN Automated 2 LI/HEP

METHAEMOGLOBIN Critical Care lab

% 2 Whole blood Lithium Heparin – Send to Main Lab

MICROSCOPY (FAECAL, FAT GLOBULES, PAEDIATRIC)

Automated 3 FRESH FAECES

NT-ProBNP Special Biochem ng/L 2 MUST BE Lithium Heparin Plasma

OCCULT BLOOD, Automated pos / neg 2 SAMPLES FROM 3 CONSECUTIVE DAYS, <5DAYS OLD

OCCULT BLOOD, HAEMOSCREEN CARDS

Automated pos / neg 2 SAMPLES FROM 3 CONSECUTIVE DAYS, <14DAYS OLD

ORGANIC ACIDS (URINE)

Chromatography

5 RANDOM URINE, FRESH

OSMOLALITY - URINE Automated mosmol/kg

(H20) 1 RANDOM URINE

OXALATE (TIMED URINE) Automated mmol/24h 6 24h URINE COLLECTION

OXALATE (RANDOM URINE) Automated mmol/mmol

creat 6 RANDOM URINE

P3NP (Intact N-terminal propeptide of type III collagen)

Special Biochem ug/L 5 SST ONLY

pH (FAECES) Chromatography

pH units 5 A MINIMUM 1g OF FAECES.W HICH MUST REACH THE LABORATORY AND BE HANDED DIRECTLY TO A MEMBER OF


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CHEMICAL PATHOLOGY

STAFF WITHIN 1 HOUR OF COLLECTION.

pH (URINE) Chromatography pH units 1 FRESH SAMPLE REQUIRED

PHENYLALANINE (BLOODSPOT) Chromatography µmol/L 2 MONITORING KNOWN CASES OF PHENYLKETONURIA ONLY

PORPHOBILINOGEN Automated qualitative 1 RANDOM URINE, FRESH - PROTECT FROM LIGHT

PORPHYRIN (URINE) Send Away

nmol/L 1

EARLY MORNING URINE

PROTEIN CREATININE RATIO (URINE)

Automated g/L

PROTEIN (URINE) Automated mg/L 1 RANDOM URINE

PROTEIN (CSF) Automated mg/L 1 CSF IN PLAIN CONTAINER

REDUCING SUBSTANCES (FAECES)

Chromatography % 5

A MINIMUM 1g OF FAECES. HICH MUST REACH THE LABORATORY AND BE HANDED DIRECTLY TO A MEMBER OF STAFF WITHIN 1 HOUR OF COLLECTION.

RENIN Special Biochem mU/L 5 EDTA, SEP, FREEZE WITHIN 30 MINS

SOMATOMEDIN C (IGF-1) Special Biochem

nmol/L 1 SST

STONE ANALYSIS Chromatography

10 RENAL CALCULUS

SWEAT CHLORIDE Trace Elements

mmol/L 4 WESCOR MACRODUCT

TACROLIMUS Send Away ug/L 3

TIMP-1 (Tissue inhibitor of matrix metalloproteinase-1)

Special Biochem µg/L

5 SST ONLY ONLY available as part of ELF test

THYROGLOBULIN Special Biochem ug/L 2 SST

THYROGLOBULIN ANTIBODIES Special Biochem KU/L 2 SST

TYROSINE (BLOODSPOT) Chromatography µmol/L 3 MONITORING KNOWN CASES OF PHENYLKETONURIA OR


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CHEMICAL PATHOLOGY

TYROSINAEMIA ONLY

VITAMIN A Chromatography μmol/L 5 SST

VITAMIN E Chromatography

μmol/L 5 SST - Vitamin E concentration is affected by plasma lipids. Vitamin E to total cholesterol ratio is a better indicator of status (Adult ref: 1.3-16.2 umol/mmol)

POINT OF CARE TESTS

BLOOD GAS (Arterial, Venous or Capillary whole blood)

POCT N/A 1 Heparinised syringe on blood gas analyser.

CARBOXYHAEMOGLOBIN POCT

% Saturation 1 Whole blood Lithium Heparin – SEND TO LAB or Heparinised syringe on blood-gas analyser.

LACTATE (BLOOD)

POCT

mmol/L 1 Lithium heparin or SST – SEND TO LAB WITHIN 10 MINUTES of venesection or Heparinised syringe on blood-gas analyser

LACTATE (CSF) POCT

mmol/L 1 Plain sample only (no anticoagulant) - SEND TO LAB WITHIN 10 MINUTES of venesection

METHAEMOGLOBIN POCT

% 2 Whole blood Lithium Heparin – SEND TO LAB or Heparinised syringe on blood-gas analyser.

TRACE ELEMENT LABORATORY TESTS

ALUMINIUM Trace Elements

umol/L 5 6ml Greiner Trace Element Na Hep tube (Royal blue top)

ANTIMONY (BLOOD)

Trace Elements

5

Adults: 6ml Greiner Trace Element Na Hep tube (Royal blue top)

Paed: 2ml Teklab Hep TE tube


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CHEMICAL PATHOLOGY

ANTIMONY (URINE) Trace Elements

5 20ml ‘Sterilin’ Universal container

ARSENIC (BLOOD) Trace Elements

umol/L 5 Lithium heparin, sodium heparin or EDTA

ARSENIC (URINE) Trace Elements


BARIUM Trace Elements

nmol/L 5 6ml Greiner Trace Element Na Hep tube (Royal blue top)

BERYLLIUM (URINE) Trace Elements

nmol/L 5 20ml ‘Sterilin’ Universal container

BISMUTH (BLOOD) Trace Elements

nmol/L 5 Lithium heparin or EDTA

BISMUTH (URINE) Trace Elements


BORON (PLASMA) Trace Elements


BORON (URINE) Trace Elements


CADMIUM (BLOOD) Trace Elements

nmol/L 5 Lithium heparin, sodium heparin or EDTA

CADMIUM (URINE) Trace Elements


CHROMIUM (BLOOD) Trace Elements

nmo/L 5 6ml Greiner Trace Element Na Hep tube (Royal blue top)

CHROMIUM (PLASMA) Trace Elements


CHROMIUM (URINE) Trace Elements



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CHEMICAL PATHOLOGY

COBALT (BLOOD) Trace Elements


COBALT (PLASMA) Trace Elements


COBALT (URINE) Trace Elements


COPPER (PLASMA)

Trace Elements

umol/L 4



COPPER (URINE) Trace Elements

umol/24hr 5 24 hour collection in a 2.5 litre container with no preservative added.

GOLD (PLASMA) Trace Elements


GOLD (URINE) Trace Elements


IODINE (URINE) Trace Elements

umol/L 5 20ml ‘Sterilin’ Universal container

IRON (URINE) Trace Elements

umol/24 hr 5 24 hour collection in a 2.5 litre container with no preservative added.

LEAD (BLOOD) Trace Elements

umol/L 5 Lithium heparin, sodium heparin or EDTA

LEAD (URINE) Trace Elements nmol/mmol

creatinine 5 20ml ‘Sterilin’ Universal container

MANGANESE (BLOOD)

Trace Elements

nmol/L 5




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CHEMICAL PATHOLOGY

MERCURY (BLOOD) Trace Elements


MERCURY (URINE) Trace Elements nmol/mmol

creatinine 5 20ml ‘Sterilin’ Universal container

MOLYBDENUM (PLASMA) Trace Elements

nmo/L 5 2ml Teklab Li Hep Trace Element tube

MOLYBDENUM (BLOOD) Trace Elements


NICKEL (PLASMA) Trace Elements


NICKEL (URINE) Trace Elements


PLATINUM (BLOOD) Trace Elements


PLATINUM (URINE) Trace Elements


SELENIUM (PLASMA)

Trace Elements

umol/L 5

Adults:6ml Greiner Trace Element Na Hep tube (Royal blue top)


SELENIUM (URINE) Trace Elements


SILVER (BLOOD) Trace Elements


SILVER (URINE) Trace Elements


STRONTIUM (PLASMA) Trace Elements



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CHEMICAL PATHOLOGY

THALLIUM (BLOOD) Trace Elements


THALLIUM (URINE) Trace Elements


TIN (PLASMA) Trace Elements


TIN (URINE) Trace Elements


TITANIUM (PLASMA) Trace Elements


TITANIUM (URINE) Trace Elements


VANADIUM (URINE) Trace Elements

nmol/L 5 20ml ‘Sterilin’ Universal container

URANIUM (URINE) Trace Elements

pmol/L 5 20ml ‘Sterilin’ Universal container

ZINC (PLASMA)

Trace Elements

µmol/l 4



TOXIC METALS SCREEN (BLOOD)

Trace Elements 2 6ml Greiner Trace Element Na Hep tube (Royal blue top)

TOXIC METALS SCREEN (URINE)

Trace Elements

2

20ml ‘Sterilin’ Universal container


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DEPARTMENT/TEST Units TAT days(working)


Lab sample storage time

HAEMATOLOGY

ESR mm/1st hour <1 2mL EDTA. Please ensure maximum fill

36-48 hours

FULL BLOOD COUNT – INCLUDING: <1

EDTA

36-48 hours

HAEMOGLOBIN g/L

WBC - WHITE CELL COUNT x10^9/L

RBC - RED CELL COUNT x10^12/L

PLATELETS x10^9/L

PCV L/L

MCV fl

MCH pg

MCHC g/L

NEUTROPHILS x10^9/L

LYMPHOCYTES x10^9/L

EOSINOPHILS x10^9/L

BASOPHILS x10^9/L

MONOCYTES x10^9/L

BLOOD FILM 1 week

G6PD SCREEN Normal/deficient 2 EDTA 3 days

PYRUVATE KINASE Normal/deficient 30 Sent away to KingsPath


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OSMOTIC FRAGILITY g/L 2

By appointment only 2 x Lithium Heparin

IM SCREEN pos/neg 1 EDTA 36-48 hours

MALARIAL SCREEN pos/neg <1 EDTA 36-48 hours

ABSOLUTE RETICULOCYTES x10^9/L <1 EDTA 36-48 hours

SICKLE SCREEN pos/neg <1 EDTA 3 days

CSF CYTOSPIN Cells present/absent <1 CSF 1 week

Haemoglobinopathy screen 3 EDTA 3 days

SOLUBLE TRANSFERIN RECEPTOR nmol/L 30 EDTA 1 month

HAEMOSTASIS (1 x 2.7 ml citrate (blue top) bottle required unless otherwise indicated) HEPARIN (ANTI-Xa ASSAY) for monitoring LMW Heparin Anti Xa assay for Rivaroxaban Anti Xa assay for Apixaban Anti Xa assay for Edoxaban Dilute Thrombin Time assay for Dabigatran

See report 2 Deliver straight to lab

1 day

D-DIMER ASSAY ug/L <1

FACTOR X ASSAY u/dL 30

Needs to be delivered directly to the coagulation laboratory within 30 minutes of venesection

Stored for up to 6 months in -70oC Freezer

FACTOR XI ASSAY u/dL 30

FACTOR XII ASSAY u/dL 30

FACTOR II ASSAY u/dL 30

FACTOR V ASSAY u/dL 30

FACTOR VII ASSAY u/dL 30

FACTOR VIII ASSAY u/dL 7


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FACTOR VIII INHIBITOR Bethesda 30

Needs to be delivered directly to the coagulation laboratory within 30 minutes of venesection


FACTOR IX ASSAY u/dL 30

FACTOR XIII SCREEN 30 2 x 2.7ml citrate

HEPARIN (APTR) Ratio <1 1 day

ACTIVATED PARTIAL THROMBOPLASTIN RATIO (APTR)

ratio <1 1 day

INR - INTERNATIONAL NORMALISED RATIO ratio <1 1 day

LUPUS ANTICOAGULANT

Pos/neg 2 2 x 2.7 ml citrate

1 day

WARFARIN (INR)

Ratio <1

1 day

THROMBOPHILLIA SCREEN must be authorised by Haematology medic Includes; Clotting screen, APCR, Protein C &S, Antithrombin, Thrombin Time

See individual tests 30

1 x EDTA, 4 x citrate Needs to be delivered directly to the coagulation laboratory within 30 minutes of venesection



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ANTITHROMBIN IU/dL 30

1 x citrate Needs to be delivered directly to the coagulation laboratory within 30 minutes of venesection


PROTEIN C IU/dL 30



PROTEIN S IU/dL 30



THROMBIN TIME Ratio 30 1 x citrate Stored for up to 6 months in -70oC Freezer

THROMBOELASTOGRAPH (TEG) 1




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VON WILLEBRAND SCREEN Includes; clotting screen, Factor VIII, VWF Ag, CBA & RiCof if indicated

See individual tests 30



VON WILLEBRAND ANTIGEN IU/dL 30



COLLAGEN BINDING ASSAY (CBA) IU/dL 30



RISTOCETIN CO-FACTOR ASSAY (RICOF) IU/dL 30




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PFA-100 seconds 1



Platelet Aggregation Screen

1

Must be by prior arrangement with laboratory 4xcitrate samples must be delivered straight to lab

BLOOD TRANSFUSION Units TAT days(working)


ANTIBODY SCREEN (AUTOMATED) 1 6mL EDTA 10 days

BLOOD GROUP (AUTOMATED) 1 6mL EDTA 10 days

AUTOMATED GROUP & SCREEN 1 6mL EDTA 10 days

FMH ml 3 or 6 ml EDTA TUBE

GROUP AND DIRECT ANTIGLOBULIN TEST (DAT) 1

Cord sample: 6mL EDTA Neonatal sample: 0.5mL

10 days

CROSS MATCH

Based on clinical need. If atypical antibodies requires 1-2 working days

6mL EDTA To be received in advance of blood requirement complying with BCSH sample validity guidelines

10 days

DIRECT ANTIGLOBULIN TEST (DAT) 1 6mL EDTA 10 days

Foetal Maternal Haemorrhage Estimation (FMH) 2 6mL EDTA 10 days


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INVESTIGATION OF TRANSFUSION REACTIONS Variable

See Transfusion Record for details To be sent upon discussion with laboratory ASAP after suspected reaction

10 days

ANTI-A/ANTI-B TITRES 2 6mL EDTA 10 days

ANTENATAL ANTIBODY TITRE OR QUANTITATION 10 6mL EDTA Referred

ANTIBODY INVESTIGATION & EXTENDED PHENOTYPING

1 6mL EDTA 10 days testing carried out if antibody screen is positive

CELL FREE FOETAL DNA TESTING 16 6ml EDTA Referred

ALL TESTS LISTED BELOW MUST BE AUTHORISED BY A HAEMATOLOGY MEDIC

HEPARIN-INDUCED THROMBOCYTOPENIA (HIT) SCREEN

1 6mL Plain clotted 10 days

HLA ANTIBODY SCREEN 13 10mL Plain clotted Referred

HLA CLASS 1 TYPING FOR PLATELET REFACTIVENESS

13 2 x 6mL EDTA 10mL Plain clotted

Referred

PLATELET ANTIBODIES (AUTO OR ALLO) 10

3 x 6mL EDTA 10mL Plain clotted If drug-related, a sample of drug is required

Referred


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FOETAL/NEONATAL ALLO-IMMUNE THROMBOCYTOPENIA

10

Maternal: 6mL EDTA 10mL Plain clotted Paternal: 6mL EDTA Neonatal: 1mL EDTA

Referred

NEONATAL ALLO-IMMUNE NEUTROPENIA 30

Maternal: 6mL EDTA 10mL Plain clotted Paternal: 6mL EDTA Neonatal: 1mL EDTA

Referred

NEUTROPHIL/GRANULOCYTE ANTIBODIES 30 10mL Plain clotted Referred

DONATH LANDSTEINER 10

6mL Plain clotted plus 6mL EDTA To be arranged with Lab for transport at 37’c. Must arrive within 30 minutes of venesection at 37’c

HERIDATRY SPHEROCYTOSIS (EMA BINDING) 7

3ml EDTA To be sent mon-wed only with required blood film

Referred


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IMMUNOLOGY

6 ML SERUM SEPARATOR GEL (SST BUFF TOP) BLOOD SAMPLE FOR ALL TESTS UNLESS OTHERWISE STATED

ACETYL CHOLINE RECEPTOR ANTIBODY nmol/L 20 Sent away if results are borderline

ADRENAL ANTIBODIES pos/neg 15

ACLA (ANTI CARDIOLIPIN ABS) u/mL 10 B2GP1 reflex tested if pos

ALLERGEN SPECIFIC IGE (RAST) kUA/L 5

ANA (see CONNECTIVE TISSUE ANA SCREEN)

ANCA (ANTINEUTROPHIL CYTOPLASMIC ANTIBODY)

pos/neg 5

ANTI COLLAGEN TYPE 2 (send away) pos/neg 20

ANTI CHOLINESTERASE (send away) pos/neg 20 AMYLOID –A (send away) pos/neg 20

ANTI C1Q (send away) pos/neg 20

ANTI-GLUTAMIC DECARBOXYLASE U/mL 20

ANTI-IGA (send away) pos/neg 20

ASPERGILLUS PRECIPITINS mg/L 10

AVIAN PRECIPITINS mg/L 10

BENCE JONES PROTEIN present/absent 10 10 ML URINE (MSU)

BETA 2 MICROGLOBULIN mg/L 5 BETA 2 GLYCOPROTEIN u/mL 15

C1 ESTERASE INHIBITOR (ANTIGENIC) g/L 10

C1 ESTERASE INHIBITOR (FUNCTIONAL) % 20 SAMPLE NEEDS FREEZING WITHIN 6 HOURS

C3 NEPHRITIC FACTOR (sent away) pos/neg 20 Only sent away for testing if C4 is normal range and C3 is below normal

CALPROTECTIN ug/g 15 FAECAL SAMPLE CARDIAC MUSCLE ANTIBODY (send away) pos/neg 20

CARTILAGE AUTOANTIBODY (send away) pos/neg 20

CENTROMERE ANTIBODIES pos/neg 5

CCP ANTIBODY u/mL 5


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IMMUNOLOGY

COMPLEMENT C3/C4 g/L 5 SPECIALIST COMPLEMENT COMPONENTS (Send away)

20 SAMPLE NEEDS FREEZING WITHIN 6 HOURS

COMPLEMENT PATHWAY FUNCTION CH50 % 20 SAMPLE NEEDS FREEZING WITHIN 6 HOURS

ALTERNATIVE COMPLEMENT PATHWAY AP50 % 20 SAMPLE NEEDS FREEZING WITHIN 6 HOURS

ALTERNATIVE COMPLEMENT PATHWAY FACTOR H mg/L 20

CONNECTIVE TISSUE ANA SCREEN pos/neg 5

COMPONENT RESOLVED DIAGNOSIS interpretive 25 SPECIALIST REQUEST, IMM CONSULTANTS ONLY

CRYOGLOBULIN pos.neg 10 MUST BE KEPT AT 37C PRIOR TO SEP’N

DNA ANTIBODIES IU/mL 5

ENA ANTIBODY SCREEN pos/neg 5

ENA ANTIBODY PROFILE pos/neg 5 REFLEX TEST ENA EXTENDED SCREEN pos/neg 15 REFLEX TEST

ENDOMYSIAL ANTIBODIES pos/neg 15

FARMERS LUNG PRECIPITINS mg/L 10

FREE LIGHT CHAINS/LIGHT CHAIN RATIO mg/l 20

GANGLIOSIDE AUTO ANTIBODY pos/neg 20

GASTRIC PARIETAL CELL AUTOANTIBODY pos/neg 10

GLOMERULAR BASEMENT MEMBRANE ANTIBODY U/mL 5

HEP2 SCREEN interpretive 10

HISTONE AUTOANTIBODY U/mL 20

HIB FUNCTIONAL ANTIBODYS mg/L 15

IMMUNOGLOBULINS + SERUM ELECTROPHORESIS g/L 5

IMMUNOGLOGULIN E (TOTAL) ku/L 5

IMMUNOGLOBULIN G SUBCLASSES g/L 20

IMMUNOGLOBULIN A –LOW CONCENTRATION g/L 20

IMMUNOFIXATION interpretive report 10 REFLEX TEST

INTRINSIC FACTOR ANTIBODIES U/ml 10


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IMMUNOLOGY

ISLET CELL ANTIBODIES pos/neg 10

LIVER AUTOANTIBODY SCREEN pos/neg 5

MAST CELL TRYPTASE u/ml 10 2 samples req’d. 1st at event, 2nd 24hrs post event

MITOCHONDRIAL (M2) ANTIBODIES u/ml 10

MYELOPEROXIDASE (MPO) ANTIBODIES u/ml 5 MUSCLE SPECIFIC KINASE AUTOANTIBODY (send away)

pos/neg 20

MYELIN ASSOCIATED GLYCOPROTEIN (send away) BTU 20

MYOSITIS Pos/neg 20

NMDA pos/neg 20 SEND AWAY

NUCLEOSOME AUTOANTIBODY U/mL 20 REFLEX TEST

OLIGOCLONAL BANDS interpretive result 10 Paired serum/CSF sample required OVARIAN AUTOANTIBODY pos/neg 20 PARATHYROID AUTOANTIBODY (send away) pos/neg 20

PEMPHIGOID/PEMPHIGUS (SKIN) ANTIBODIES pos/neg 10

PNEUMOCOCCAL (functional antibodies) mg/ml 15

PREVNAR SEROTYPES 20 SEND AWAY

PROTEINASE 3 (PR3) ANTIBODIES u/ml 5

PURKINJE CELL AUTOANTIBODY (Hu,Yo ) pos/neg 15

PARANEOPLASTIC AUTOANTIBODIES pos/neg 25

RHEUMATOID FACTOR QUANTITATION iu/mL 5

SCANNED MONOCLONAL COMPONENT g/L 5 Total protein essential

SCLERODERMA Pos/neg 20

SKELETAL MUSCLE ANTIBODIES pos/neg 10

TETANUS ANTIBODIES iu/ml 10

THYROID PEROXIDASE ANTIBODIES u/ml 5


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IMMUNOLOGY

TISSUE TRANSGLUTAMINASE ANTIBODIES IgA u/ml 5

TISSUE TRANSGLUTAMINASE ANTIBODIES IgG u/ml 5

VGCC ANTIBODIES pmol/L 20 SEND AWAY

VGKC ANTIBODIES pmol/L 20 SEND AWAY


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FLOW CYTOMETRY

LEUKAEMIA/LYMPHOMA SCREEN interpretive report 5 EDTA 4.5 mL or Bone Marrow, <72 hrs old Monday – Friday 12:00 pm

Lymphocyte Subsets (T, B and NK Subsets) Interpretive comment 10 EDTA 4.5 ml, <72 hrs old Monday – Friday 12:00 pm

Neutrophil Oxidative Burst Interpretive comment 5

Lithium Heparin 3ml <48 hrs old Monday – Wednesday By appointment only

PNH Screen Interpretive comment 5 EDTA 4.5 ml, <72 hrs old Monday – Friday 12:00 pm

Neutrophil Phagocytosis Interpretive comment 5

Lithium Heparin 3ml <48 hrs old Monday – Wednesday By appointment only

T cell receptor (TCR) repertoire (TCR V) 4 EDTA 4.5 ml, <72 hrs old Monday – Friday 12:00 pm

Memory B cell subsets (CVID) % B memory Subsets 10 EDTA 4.5 ml, <72 hrs old Monday – Friday 12:00 pm

Memory T cell Subsets % T memory Subsets 10 EDTA 4.5 ml, <72 hrs old Monday – Friday 12:00 pm

Hairy Cell Leukaemia Screen interpretive report 5 EDTA 4.5 ml, <72 hrs old Monday – Friday 12:00 pm

T Cell Subsets (CD4 count) % & Abs count 5 EDTA 4.5, <72 hrs old Send FBC result. Monday – Friday 12:00 pm

Therapeutic Antibody Evaluation Rituximab (Rituxan) (CD20)

B cells % & Abs Count 5 EDTA 4.5, <72 hrs old Monday – Friday 12:00 pm


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MOLECULAR PATHOLOGY

FOR PAEDIATRIC PATIENTS SEND AS MUCH SAMPLE (IN EDTA) AS AVAILABLE, UP TO RECOMMENDED ADULT VOLUMES WHERE POSSIBLE AS DETAILED BELOW

BCR-ABL TYROSINE KINASE DOMAIN MUTATION PRESENCE/ABSENCE 14* CONTACT LABORATORY

BCR-ABL QUANTIFICATION

BCR-ABL / ABL RATIO BCR-ABL /ABL IS corrected value

14*

PB: 12ML EDTA BM: 2 ML EDTA (TO BE RECEIVED WITHIN 24 HRS OF COLLECTION)

BRAF V600E % MUTANT 14* PB: 6ML EDTA BM: 2 ML EDTA Histological samples

BRAF V600K % MUTANT 14* PB: 6ML EDTA BM: 2 ML EDTA Histological samples

CHIMERISM POST TRANSPLANT % DONOR CONTRIBUTION 14* PB: 6ML EDTA BM: 2 ML EDTA

DPYD GENOTYPING PRESENCE/ABSENCE 14* PB: 6ML EDTA

EGFR HOTSPOT MUTATION ANALYSIS PRESENCE/ABSENCE 14* Histological samples (With tumour density assessment)

FACTOR V LEIDEN POSITIVE / NEGATIVE 14 PB: 6ML EDTA

HAEMOCHROMATOSIS GENOTYPE (HFE) INTERPRETIVE REPORT 14* PB: 6ML EDTA

HLA B27 (MOLECULAR CONFIRMATION) POSITIVE / NEGATIVE 14 PB: 6ML EDTA

HLA B57:01 POSITIVE / NEGATIVE 14* PB: 6ML EDTA

HLA DISEASE ASSOCIATION - NARCOLEPSY, COELIAC DISEASE

N/A 14 PB: 6ML EDTA

HLA DISEASE ASSOCIATION - BECHETS, BIRD SHOT CHORIORETINOPATHY

N/A 14 PB: 6ML EDTA, SEND TO TOOTING

JAK2 V617F MUTATION % MUTANT 14* PB: 6ML EDTA


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MOLECULAR PATHOLOGY

FOR PAEDIATRIC PATIENTS SEND AS MUCH SAMPLE (IN EDTA) AS AVAILABLE, UP TO RECOMMENDED ADULT VOLUMES WHERE POSSIBLE AS DETAILED BELOW

LOH 1p/19q TESTING LOSS / NO LOSS 14* H&E STAINED SLIDE WITH THE HIGHEST DENSITY OF TUMOUR CELLS IDENTIFIED. 6 × 10µm UNSTAINED SECTIONS. PB: 6ML EDTA – AS NORMAL CONTROL

MGMT METHYLATION ANALYSIS METHYLATED / UNMETHYLATED

14* H&E STAINED SLIDE WITH THE HIGHEST DENSITY OF TUMOUR CELLS IDENTIFIED. 6 × 10µm UNSTAINED SECTIONS. PB: 6ML EDTA – AS NORMAL CONTROL

MPN PANEL EXTERNAL REPORT 14* PB: 6ML EDTA

MYD88 MUTATION % MUTANT 14* PB: 6ML EDTA

BM: 2 ML EDTA Histological samples

MYELOID GENE PANEL EXTERNAL REPORT 14* PB: 6ML EDTA

PROTHROMBIN FACTOR II MUTATION POSITIVE / NEGATIVE 14 PB: 6ML EDTA

T & B CELL CLONALITY STUDIES INTERPRETIVE REPORT 21* VARIOUS (PLEASE CONTACT LABORATORY)

Test turnaround times defined by National Test directory at NHSE

laboratory medicine investigations

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